Fractional flow reserve at the crossroad between revascularization and medical therapy

The current understanding of the pathophysiology of coronary artery disease relies on the potential adverse effect of myocardial ischemia (1). Even though the ischemia hypothesis has been placed at the core of the evaluation of patients with stable coronary artery disease, no clear evidence supports the benefit of revascularization in terms of hard clinical endpoints namely myocardial infarction and death (2).